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Ophthalmic considerations in fronto-ethmoidal mucocoeles.

V J Lund1, M E Rolfe

  • 1Institute of Laryngology and Otology, London.

The Journal of Laryngology and Otology
|July 1, 1989
PubMed
Summary

Fronto-ethmoidal mucocoeles often cause eye problems like proptosis and diplopia. Surgical treatment (fronto-ethmoidectomy) effectively resolves most ophthalmic issues, though some patients may require further management for persistent diplopia.

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Area of Science:

  • Ophthalmology
  • Otorhinolaryngology
  • Neurosurgery

Background:

  • Fronto-ethmoidal mucocoeles are benign cystic masses that can cause significant ophthalmic complications.
  • Ophthalmic manifestations include proptosis, ocular displacement, diplopia, and restricted ocular motility.

Purpose of the Study:

  • To evaluate the pre- and post-operative ophthalmic consequences of fronto-ethmoidal mucocoeles.
  • To assess the efficacy of external fronto-ethmoidectomy in resolving these ophthalmic issues.

Main Methods:

  • Prospective study of 22 patients with fronto-ethmoidal mucocoeles.
  • Surgical intervention via external fronto-ethmoidectomy.
  • Pre- and post-operative ophthalmic assessments.

Main Results:

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  • Proptosis and ocular displacement resolved completely in most patients post-surgery.
  • Transient diplopia exacerbation occurred in one third of patients, with most experiencing resolution.
  • Persistent diplopia was noted in seven patients, requiring medical or surgical intervention.

Conclusions:

  • External fronto-ethmoidectomy is effective in managing ophthalmic complications of fronto-ethmoidal mucocoeles.
  • Persistent diplopia may result from superior oblique underaction, possibly due to trochlear displacement.
  • Careful surgical technique, including trochlear re-attachment, may prevent persistent diplopia.